Loading...
HomeMy WebLinkAbout0310 YICBOFI LI I~iO - ~ Legibi2ity oi ~?ritins, t,ypin~ { or printir~ nr~ssti sfac tory f n ; this docnsent ior uicroiilaing • • 144544 31 OH10 DEPARTMENT OF HEALTH Rrt t)nt N OIVi510N OF VITAL STATISTIGS 4att p,k Ne Anman R.r t~~.+ 3100 CERTIFICATE OF DEATH Retniur • No _ ~ _ s ~ PLA E OF OEATH ) l. 1 CE ~V~'htrc .ltctavd I~ve ~n~t~tw+~n es~ g e CJU?~T11 Jtnat Atforc adfil+J~Hw) ~ i H~miiton ~ . sr~~E Ohio . cou?+~. Hu~ilto~ . • C~i~. v~U~GE O~ IOC~t~vr. ~ lENG1N O~ STA1 ~N i• a. C~i~, v~ll~GE. O~ tOCA11p11 - - f t Saganore Height~ S~~aaore Height~ ~ d NAYE Of . .e A.. ~er..~ .~~f~r~u.~• ~r~~ .r.r~~ rJ.ire~~~ I. 3TlEE/ ADD!! ~ - ~ - Npyli~l O~ ~ iwsn.uno.. 831~ ~Mf~ltdl Qt. ~ $313 (~iMi~~ ~r - - - ~ • ~S ~?ACf Oi OE~iN ~wS~D[ C1Tf I~M~fi° • If fESfpENn INSIO[ C1T1 UYIi39 ! l. IS ~ESIOENCE ON A l~~M?+ tEf x r~r0 , ` r!S ~ a0 rES ~ ~ NO ~7- ~ ~ NAME OF f~n~ M~ddit tt ~ OAt~ `~1-~n~A a~ o~ OECEASEO ~ inrc o~ ?nN~, ose h ' 1 P J. Hyman ~ OEAiN Peb. 20 1966 ~ S SEIt s tOtO~ O! ~~?CE ' 7 q~tt~ED ~ NEVER r~~u[D t Owit Oi ~inN A~ rJ~ I/ ~ t?Mr 11 ~ ZI Me I fr~~ InrA/~~ ~.M.u~~, D~?~ ' H.~.. .M~• 1 Male 'Nhi t! w~pOwEO O~VOlCED 7~Z3~1896 69 ~ z ~a. uw~i occur.r~or. ~..f 1.,~,; 10? IINO OI WSINlSS Of IMOUSif? 11 uirMrua . c~nitM or- ~ dW M~ N~/ N r~.w~ Id~. ~~~w .N.~W • ~ . .~~Ir . ' Real Bstatt Broker Russia i w Ug/? i~~ ~ ) rATNt~ S NwrE ~ - : u. YOTMEt'3 MAIOEM NAME- - ~ - . i ~ unk _ _ unt ~S w~S GFCE.?SFO f~E~ u s •~rEO W~CES+ is soc~~i stN~~n wo INFORMANfi'S $IGFlAT l~ii~- -Ade~n, ~ ' Y. • • st~~ .r a ~r • /Ni~ ~l nru.tl ~ '~es W v~~ Z~3-24-8865 Mss. ~ora H 8313 (~ilada Dr. ' CAUSE OF DEA N {.ve• ur.r ~r. /r~~ •n p ~r? iN1lpAl ~E7MEEN ~ ~Ui ~ DfA1N wAs GUSEO ~T• ~'D 'M,~/,j~ ~ - ~AMO ~fATM ~ , ~r..tnuiE fwuSE ~•i 7~j~ 1F/V~I ~4ii~~ ~y - ~I ~ ~ e ..~.1~u ~ . ~o• 0!!f f0 /il ~ r Mrb ~r. r .,.i ~o ~ •I..~r •r•~ ~ - - - - - ~ ~ • ,r~u~R tbe .•J~.~ hr~R ii~~r l~u. OUE TO la~ ~ i~- ' Y , ~ ?.n u o..u s.~nr~u.. CNNnMf to.•~~~•.•.~ .e ~u•. •m n w 1~~~wH O~~UN CNM11M t~~~ r~ M d~l N. 1M4~ AY10?SY F ~ " ~lMOlMtO~ ~ rtf ? NO~ ~ ~ ?0~ ACCtDENT SYIUDE- - -IIpM1UpE - ?p? DESC~t~E MOw ~H~ut~ OtN~~EO . E¦r.. ~u~.~ •,l ~+I~r1 n ~rt I N ~rt • ib~ 11.) ~ ' ,j . - ~ ~ r, v t ]Oc. tIME p%'-H~a. JMe~fj~. Dn )'r...' _ _ ~ V IMIY/Y ~ ~ C ~ ?0/_ ~N1Ut1I OCCUflEp -]0~. /IACE Ot ~NlU~7 ~ r _ ~ .I be~r. ?01. QTt. vtllAGE. O~ IOCATIOM Cp11~lT?. ;tATt ~ MMIIE At MOT MIIIIE 1 'w~. I~.r.,.~ .n..f ~.'i.~ ~(J~ . rt..7 • W OR C AT w0~ • i r~?~.~ ~y _ : 1 ~+~~~l~f ~M /~~ru~/ !f ' w l~J 4 r , ~ ~ ~ ~~Y i~! l~~r ~ir ~~~i e f/iyL •r.~.r~t rI ---~tQ~ !'t w.,.. ~A. Ji:, r.~.~ r. rA~ ~iit ~ nr bordi/~i. I~~~ ib ~~~~~i ~f~Nl. ! ~ ~ SIGNATU - in.~... • i» ~woeessARtIC`1_~ IG1_AUER, M. p~ ~ tT~. ~iia+EO } ' / : c'2S _ . . ! A: t 1)o Wl~wl, Cf[rA- 1 OATE . ~ Tk aME O~ EMEtft? O~ CtEn~TOf1t ~ I j 1 , nr cwnt~t fSpu~ "~`i'~i i~2I-1966 i Lick Rurt Ceaeterp j Ciacinaati Ohio j t• NwrE W E1yAWEt ~~~c ro . 7f. fUNE D~~EQOf~S S~C~1At fE ~~~C, »p ~ ' ; Jact Srofe ~954 A ~ (,~4-e.:Q 2047 ~ ~e ~uNE~w~ ?~er wND nOO~ESi ~SnEf* NO 1 IdT?) (STAft~ ~ Weil Punessl Hoo?e 3901 Reading Rd. Cincinaati Ohio ~ 77 OwiE ~Et 0~~ t~ S1~A!'S S~C.N~iy~ SIN~tEGiS~U?~'S SIG«ATUfE i f ~ , j` , > . 0~ Q~IgI~FiL ~EC DEO ~ - ~R~ - ~ " g HI~MILTON COUNTY HEALTH DEPARTMENT ~/~r O Division of Vital Statistics •~~f~." • : ~ ~ J~~~ ~ , APR ' " I • 1 S f~ ; , • ,~s ~ ~ : ~ ~ ~~s is to certii~ t ~at certification No.~~e?~ ;r , ;y'~"~:~_ 1 144544 e ~~erif:~x c:~,;~y of t2-;~ uri~ i:~a~~JD!~~~ ~ ~ - . - ' Rd ER PGi i fZa~. G~L~~~C" •-.y :Z. . ~E C~U~:~?ti ~cate o fi~c: ir~ this ~ffice. ~ T. LUC • 9';;,~, - FIORIDA - - -Hegistrar ~ i w+~;..~ f~r.' <'J~i - ~.,~Q~~ ~ s`~~'~~ , 0 R (Per) Z/-~~-------. Deputy ` r ~ ' aooK ~ 14~ ~Qg ` a y~ Y`~:~. ~ = . - ` I '~s~c. ~,z :~a